Orbital Complications: Nasolacrimal Duct Injury After Endoscopic Sinus Surgery

2021 ◽  
pp. 35-39
Author(s):  
Dennis M. Tang ◽  
Raj Sindwani
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Nasolacrimal Duct ◽  
Sinus Surgery ◽  
Orbital Complications

Orbital Complications in Functional Endoscopic Sinus Surgery

1993 ◽  
Vol 109 (5) ◽  
pp. 814-820 ◽  
Author(s):  
Jacquelynne P. Corey ◽  
Robert Bumsted ◽  
William Panje ◽  
Ari Namon
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Nasolacrimal Duct ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Previous Surgery ◽  
Steroid Use ◽  
Orbital Complications ◽  
Lateral Canthotomy

Endoscopic sinus surgery can result in both minor and major complications. Among these, orbital complications—including retroorbital hematoma—are among the most feared. Injuries can be direct or indirect from pulling on diseased structures. A retrospective chart review of 616 endoscopic sinus procedures revealed eight orbital complications in seven patients. These included two medial rectus injuries, five orbital hemorrhages, and one nasolacrimal duct injury. Predisposing factors may include hypertension, lamina papyracia dehiscences, extensive polypoid disease, previous surgery, inability to visualize the maxillary ostia, violent coughing or sneezing, and chronic steroid use. Suggested management in the literature includes lateral canthotomy, steroids, and mannitol with ophthalmologic consultation. Opening of the wound by means of an external ethmoidectomy incision has also been suggested. We suggest that adding orbital decompression by means of multiple incisions into the periorbita should be added for fully effective relief. A “management” tree of decision parameters relevant to orbital complications is presented.

scholarly journals Endoscopic Visualization of the True Maxillary Ostium Following Uncinectomy

2019 ◽  
Vol 99 (6) ◽  
pp. 384-387 ◽  
Author(s):  
Omar H. Ahmed ◽  
Marissa P. Lafer ◽  
Ilana Bandler ◽  
Elcin Zan ◽  
Binhuan Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Chronic Rhinosinusitis ◽  
Study Design ◽  
Endoscopic Sinus Surgery ◽  
Nasolacrimal Duct ◽  
Sinus Surgery ◽  
Academic Hospital ◽  
Preoperative Ct

Objectives: To examine the frequency in which angled endoscopes are necessary to visualize the true maxillary ostium (TMO) following uncinectomy and prior to maxillary antrostomy. Additionally, to identify preoperative computed tomography (CT) measures that predict need for an angled endoscope to visualize the TMO. Study Design: Retrospective study. Setting: Tertiary academic hospital. Patients and Methods: Patients who underwent endoscopic sinus surgery (ESS) between December of 2017 and August of 2018 were retrospectively identified. Cases were reviewed if they were primary ESS cases for chronic rhinosinusitis without polyposis and if they were at least 18 years of age. Results: Sixty-three maxillary antrostomies were reviewed (82.5% were from bilateral cases). Thirty-five cases (55.6%) required an angled endoscope in order to visualize the TMO. Of the preoperative CT measures examined, a smaller sphenoid keel-caudal septum-nasolacrimal duct (SK-CS-NL) angle was significantly associated with need for an angled endoscope intraoperatively to visualize the TMO (17.1° SD ± 3.2 vs 15.0° SD ± 2.9; P = .010). Conclusion: Angled endoscopes are likely required in the majority of maxillary antrostomies to visualize the TMO. This is important to recognize in order to prevent iatrogenic recirculation. The SK-CS-NL angle may help to identify cases preoperatively which require an angled endoscope to identify the TMO during surgery.

Pharmacological pupil dilatation after sinus surgery

2021 ◽  
Vol 14 (1) ◽  
pp. e236666
Author(s):  
Bassem Mettias ◽  
Tahir Islam ◽  
Theodoros Valsamakis
Keyword(s):  
Case Report ◽  
Endoscopic Sinus Surgery ◽  
Rare Case ◽  
Sinus Surgery ◽  
Lacrimal Duct ◽  
Postoperative Assessment ◽  
Rare Case Report ◽  
High Concern ◽  
Flow Through ◽  
Orbital Complications

Orbital complications after endoscopic sinus surgery are serious problems. Inadvertent contamination of the eye by pharmacological solution can lead to early postoperative anxiety to patients and high concern to surgeons. This is a rare case report of retrograde epinephrine flow through lacrimal duct in sinus surgery with learning tips during postoperative assessment for reassurance in temporary pharmacological effect rather than serious complication.

Bony nasolacrimal duct dehiscence in functional endoscopic sinus surgery: radiological study and discussion of surgical implications

2015 ◽  
Vol 129 (S3) ◽  
pp. S35-S40 ◽  
Author(s):  
M J Ali ◽  
J Murphy ◽  
P J Wormald ◽  
A J Psaltis
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sinus Surgery ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Retrospective Case ◽  
Computed Tomography Images ◽  
Before And After ◽  
Surgically Induced

AbstractObjectives:To analyse the radiological features of the bony nasolacrimal duct before and after functional endoscopic sinus surgery, and document the incidence of surgically induced dehiscence.Methods:A retrospective case series analysis was conducted of 63 consecutive patients who underwent uncinectomy as a part of 118 functional endoscopic sinus surgical procedures. All patients underwent pre- and post-operative computed tomography scans. Axial computed tomography images at the level of maxillary sinus were evaluated for the presence of bony nasolacrimal duct dehiscence, osteitis and completeness of uncinectomy.Results:The rate of nasolacrimal duct dehiscence prior to surgery was 6.8 per cent (8 out of 118 cases). Nasolacrimal duct dehiscence as a consequence of surgery was observed in 3.3 per cent of cases (4 out of 118), with a further 4.2 per cent (5 out of 118) showing post-operative reactive bony change of the nasolacrimal duct in the absence of dehiscence.Conclusion:The incidence of nasolacrimal duct injury observed was much lower than that previously reported in the literature.

scholarly journals Outcomes of endoscopic sinus surgery for sinusitis-induced intracranial abscess in patients undergoing neurosurgery

2019 ◽  
Vol 47 (2) ◽  
pp. E12 ◽  
Author(s):  
Megumi Koizumi ◽  
Miho Ishimaru ◽  
Hiroki Matsui ◽  
Kiyohide Fushimi ◽  
Tatsuya Yamasoba ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Length Of Stay ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Neurosurgical Procedures ◽  
Fungal Sinusitis ◽  
Intracranial Abscess ◽  
Diagnosis Procedure Combination ◽  
Intracranial Complications ◽  
Orbital Complications

OBJECTIVEAlthough sinusitis-induced intracranial complications rarely occur in the current era of antibiotics, they can induce neurological symptoms or death. The authors of this study investigated the association between endoscopic sinus surgery (ESS) and outcomes in patients who had undergone neurosurgical procedures for sinusitis-induced intracranial abscess.METHODSThe authors obtained data on patients with sinusitis-induced intracranial abscess from the Japanese Diagnosis Procedure Combination inpatient data for the period from 2010 to 2017. They excluded patients with fungal sinusitis, orbital complications, immunodeficiency, and malignant disease. They also excluded patients who had received antifungal agents, chemotherapy, immunosuppressants, and antidiabetic drugs. Eligible patients were divided into those with and those without neurosurgical procedures. Propensity score–adjusted regression analyses were performed to examine the association between ESS within the same hospitalization and outcomes (mortality, blood transfusion, readmission, revision neurosurgery, and length of stay).RESULTSOf the 552 potentially eligible patients, 255 were treated with neurosurgical procedures, including 104 who underwent ESS within the same hospitalization and 151 who did not. ESS was not significantly associated with mortality (OR 0.54, 95% CI 0.05–5.81, p = 0.61), blood transfusion (OR 1.95, 95% CI 0.84–4.51, p = 0.12), readmission (OR 0.86, 95% CI 0.34–2.16, p = 0.75), revision neurosurgery (OR 0.65, 95% CI 0.24–1.74, p = 0.39), or length of stay (percent difference −10.8%, 95% CI −24.4% to 5.1%, p = 0.18).CONCLUSIONSThe present study suggests that ESS may not have significant benefits with respect to reducing mortality, blood transfusion, readmission, revision neurosurgery, or length of stay.

scholarly journals A Case of Transient Visual Disturbance and Ocular Paresis after Endoscopic Sinus Surgery

2020 ◽  
Vol 27 (1) ◽  
pp. 46-49
Author(s):  
Ji Soo Lee ◽  
Jeong Hwan Yang ◽  
Joong Seob Lee
Keyword(s):  
Surgical Treatment ◽  
Chronic Rhinosinusitis ◽  
Local Anesthetics ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Visual Disturbance ◽  
Sinus Surgery ◽  
Ocular Muscle ◽  
Orbital Complications ◽  
Muscle Toxicity

Endoscopic sinus surgery (ESS) is widely used as standard surgical treatment for chronic rhinosinusitis. Orbital complications of varying degrees occurred during ESS have been widely reported. If the orbital symptoms occurred immediately after surgery, ocular damage associated with surgery is suspected if the patient’s preoperative ocular function was patent. If immediate action is not taken, permanent visual loss might develop, so it is very important to diagnose orbital complications and take appropriate action. In our case, there was no definite intraorbital hemorrhage when sudden visual loss was noted. The symptoms were fully recovered without further treatment and it is clinically suspected to be caused by transient ocular muscle toxicity of local anesthetics.

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